Alteplase improves acute cerebral infarction by improving neurological function and cerebral hemodynamics

Zhao, Jing; Sun, Yao; Fang, Yanyu; Liu, Xiaokai; Ji, Fangchao; Liu, Hongbin

doi:10.1080/26895293.2021.1898052

Cited by 2 publications

(4 citation statements)

References 23 publications

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“…SAH‐related complications, including symptomatic vasospasm (new focal neurological signs or deterioration of consciousness, excluding other definitive causes), 17 delayed cerebral infarction (new infarction on radiological imaging), rebleeding (new or expanded hemorrhage on CT), encephaledema, and seizure. Symptomatic vasospasm and delayed cerebral infarction were defined as delayed cerebral ischemia (DCI) 18–20 . Clinical prognosis was assessed using the modified Rankin Scale (mRS) at 3 months and 12 months following discharge, which was recorded by outpatient records and telephone interview.…”

Section: Methodsmentioning

confidence: 99%

“…Symptomatic vasospasm and delayed cerebral infarction were defined as delayed cerebral ischemia (DCI). 18 , 19 , 20 Clinical prognosis was assessed using the modified Rankin Scale (mRS) at 3 months and 12 months following discharge, which was recorded by outpatient records and telephone interview. According to the mRS, the prognosis was categorized as either poor outcome (mRS 2‐6) or favorable outcome (mRS 0‐1).…”

Section: Methodsmentioning

confidence: 99%

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Development of a nomogram for predicting clinical outcome in patients with angiogram‐negative subarachnoid hemorrhage

Zhang

et al. 2021

CNS Neurosci Ther

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To the best of our knowledge, this is the largest clinical retrospective study in AN‐SAH patients, and is the first time to establish accurate predictive models paired with bleeding pattern. Background Angiogram‐negative subarachnoid hemorrhage (AN‐SAH) has a definite incidence of delayed cerebral ischemia (DCI) and poor clinical outcomes. The purpose is to screen independent factors and establish a nomogram to guide the clinical therapy and assess post‐discharge prognosis. Methods We identified 273 consecutive patients referred to our institute from 2013 to 2018 for AN‐SAH. A nomogram to predict poor outcomes was formulated based on the multivariable models of independent risk factors. The accuracy and discrimination of nomograms were determined in training and internal validation cohorts. Results The overall poor outcome rates of AN‐SAH were 14.3% and 8.7% at 3 months and 12 months, respectively. In addition, perimesencephalic AN‐SAH (PAN‐SAH) presented with a more unfavorable prognosis compared with non‐perimesencephalic AN‐SAH (NPAN‐SAH). The clinical prognosis was associated with the World Federation of Neurosurgical Societies scale (WFNS) (odds ratio, 3.82 [95% CI, 1.15‐12.67] for 3‐month outcome; and odds ratio, 31.69 [95% CI, 3.65‐275.43] for 12‐month outcome), Subarachnoid hemorrhage Early Brain Edema Score (SEBES) (odds ratio, 10.39 [95% CI, 1.98‐54.64] for 3‐month outcome; odds ratio, 10.01 [95% CI, 1.87‐53.73] for 12‐month outcome), and symptomatic vasospasm (odds ratio, 3.16 [95% CI, 1.03‐9.70] for 3‐month outcome; odds ratio, 5.15 [95% CI, 1.34‐19.85] for 12‐month outcome). The nomogram was constructed based on the above features, which represented great predictive value in clinical outcomes. Conclusions Symptomatic vasospasm, high WFNS, cerebral edema, and NPAN‐SAH after hemorrhage were associated with poor outcome of AN‐SAH. The nomogram with WFNS (3‐5), SEBES (3‐4), vasospasm, and NPAN‐SAH represented a practical approach to provide individualized risk assessment for AN‐SAH patients.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Development of a nomogram for predicting clinical outcome in patients with angiogram‐negative subarachnoid hemorrhage

Zhang

et al. 2021

CNS Neurosci Ther

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“…Early thrombolytic therapy can re-canalize occluded blood vessels, restore blood flow, save ischemic penumbra brain tissue, and effectively improve patient's prognosis. A third-generation thrombolytic drug, alteplase, is an endogenous enzyme [3,21]. Although it is difficult to activate plasminogen without fibrin, alteplase can easily activate plasminogen in the thrombus.…”

Section: Discussionmentioning

confidence: 99%

“…When the central nervous system was relieved, the patients' symptoms were relatively reduced, and their quality of life was improved. After treatment, the total effective rate of the combined group was higher than that of the alteplase group, indicating that the combined alteplase and butylphthalide treatment had a better curative effect, which may be related to the fact that butylphthalide can directly improve local symptoms in the brain by reducing the area of local infarction and increasing the number of blood capillaries [3,10,21]. At the same time, there was no significant difference in the incidence of side effects between the combination group and the alteplase group, indicating that the combination of butylphthalide therapy did not increase the risk, and that the combination is safe and effective.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of alteplase intravenous thrombolysis combined with butylphthalide in patients with acute severe cerebral infarction

Wang¹,

Che²

2022

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Introduction:The aim of the study was to investigate the effectiveness of alteplase intravenous thrombolysis combined with butylphthalide in patients with severe cerebral infarction. Material and methods: From February 2018 to March 2019, 100 patients with severe cerebral infarction in Rongcheng People's Hospital were recruited and randomly divided into two groups, i.e., alteplase intravenous thrombolysis treatment group and alteplase intravenous thrombolysis combined with butylphthalide treatment group. The efficacy of treatment methods was compared between the two groups by analyzing National Institutes of Health Stroke Scale (NIHSS) scores of patients on the first, seventh, and fourteenth days after treatment. Quality of life of patients was evaluated using Barthel scale before and after treatment, and also, the incidence of adverse reactions was compared between the two groups. Results: The therapeutic effect and quality of life in the alteplase intravenous thrombolysis combined with the butylphthalide group were better compared with patients in the alteplase intravenous thrombolysis group. The total effective rate of the alteplase intravenous thrombosis group was 80%, and that of the alteplase intravenous thrombosis combined with butylphthalide group was 100%; the latter treatment was more effective (p < 0.05). NIHSS scores of the patients at 1, 7, and 14 days after treatment were better in the former group than in the latter (p < 0.05). Moreover, the probability of adverse reactions in the alteplase intravenous thrombosis group was 6%, and the probability of adverse reactions in the alteplase intravenous thrombosis combined with butylphthalide group was 4%. The incidence of adverse reactions in the former group was similar to that in the latter (p > 0.05). In other words, the combination of drugs did not increase the incidence of adverse reactions. Conclusions: Alteplase intravenous thrombolysis combined with butylphthalide in the treatment of severe cerebral infarction is safe, and may significantly improve patient's neurological function and quality of life without adverse reactions.

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Alteplase improves acute cerebral infarction by improving neurological function and cerebral hemodynamics

Cited by 2 publications

References 23 publications

Development of a nomogram for predicting clinical outcome in patients with angiogram‐negative subarachnoid hemorrhage

Development of a nomogram for predicting clinical outcome in patients with angiogram‐negative subarachnoid hemorrhage

Effectiveness of alteplase intravenous thrombolysis combined with butylphthalide in patients with acute severe cerebral infarction

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